Sommers Benjamin D
Benjamin D. Sommers ( bsommers@hsph. harvard. edu ) is a professor of health policy and economics in the Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, and an associate professor of medicine at Brigham and Women's Hospital, both in Boston, Massachusetts.
Health Aff (Millwood). 2020 Mar;39(3):502-508. doi: 10.1377/hlthaff.2019.01416.
The Affordable Care Act (ACA) led to the largest expansion of health insurance in the US in fifty years, bringing the uninsurance rate to its lowest recorded level in 2016. But even at that point, nearly thirty million people lacked health insurance, and millions more still struggled to afford needed medical care. Recent studies also indicate a partial erosion of the ACA's coverage gains since 2017. This article identifies the underlying causes of these problems and evaluates potential policy remedies. Topics include the slow but steady growth of state expansions of eligibility for Medicaid; new waiver approaches in Medicaid, including work requirements; high cost sharing and premium growth in both the Marketplaces and employer coverage; and proposed systemic overhauls such as Medicare for All.
《平价医疗法案》（ACA）带来了美国五十年来最大规模的医疗保险扩张，使无保险率在2016年降至有记录以来的最低水平。但即便如此，仍有近3000万人没有医疗保险，还有数百万人仍在为负担所需医疗护理而苦苦挣扎。近期研究还表明，自2017年以来，ACA所取得的覆盖范围扩大成果出现了部分缩减。本文确定了这些问题的根本原因，并评估了潜在的政策补救措施。主题包括医疗补助计划资格的州扩张缓慢但稳定的增长；医疗补助计划中的新豁免方法，包括工作要求；市场保险和雇主提供的保险中高额的费用分摊和保费增长；以及诸如全民医疗保险等系统性全面改革提议。
